Individual
LUIS A DESTARAC
Active
Individual
LUIS A DESTARAC
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
K0712
TX
207KA0200X
Allergy Physician
K0712
TX
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
K0712
TX
207RP1001X
Pulmonary Disease Physician
Primary
K0712
TX
Other
Enumeration date
03/27/2006
Last updated
11/21/2019
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